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Isolation

Care of babies requiring isolation in the Neonatal Critical Care Unit

Why does my baby need to be isolated?

How do germs spread?

It is common for babies who have long-term stays in hospital to be introduced to germs such as bacteria and viruses. Germs can be spread in a number of ways including by contact with other people or contaminated surfaces (e.g. touching a baby or cot without washing your hands first), droplets from coughing or sneezing, and less commonly, through the air. There are a number of routine measures in place in the Neonatal Critical Care Unit (NCCU) to prevent germs from spreading between babies e.g. handwashing, dedicated equipment, and frequent cleaning of commonly used items. However, from time to time, a baby may become colonised or infected with a germ that requires special infection control precautions.

Infection means that the germ is in, or on, the body and making your baby sick. Signs of infection include fever, pus from a wound, and pneumonia. Colonisation means the germ is on, or in, your baby’s body but not causing an infection. If your baby is colonised he/she will not experience sickness or symptoms. However, because the germ is present, it can be spread to other babies in the NCCU. In a very small number of cases, colonisation may result in infection from that organism later on. For this reason your baby’s doctor will continue to carefully monitor your baby including the results of any tests.

What types of germs are we concerned about?

Because of the need to use antibiotics in hospitals to treat infections, some germs (mainly bacteria) may develop resistance to one or more of these antibiotics. Resistance means the antibiotic no longer works against that particular germ. Examples of antibiotic resistant bacteria include: methicillin resistant Staphylococcus aureus (MRSA); extended spectrum Beta-lactamase-producing organisms (ESBLs); and vancomycin resistant enterococci (VRE). These germs usually live in the nose or bowel (gut).

These bacteria do not cause more serious infections but it is more difficult to choose the right antibiotic to treat them. It is important to remember that antibiotic resistant bacteria can be treated.

Other infections such as influenza (flu), gastroenteritis (vomiting and diarrhoea), and childhood diseases such as chickenpox, are also a concern in NCCU because premature and sick babies have very limited resistance to infection.

How do we stop the spread of these germs?

In some circumstances, additional infection control precautions will be required to stop the spread of the germ to other babies. This will depend on the type of germ and how it is spread. Precautions can include the following:

Placing your baby in a single room and having anyone entering the room wearing a gown, gloves and/or mask.

Keeping your baby in their incubator/cot in the pod and placing a sign in their cot area advising of the precautions that need to be taken.

It is usually not necessary for you to take precautions with your baby but NCCU or Infection Control staff will advise you if you need to do anything extra.

Your baby may need to be isolated for a short period of time e.g. days (or until they no longer have symptoms), or longer (weeks) depending on the type of germ. In some instances regular tests or swabs may be collected from your baby to find out if they are still carrying the germ.

Occasionally, treatments and procedures may need to be delayed until your baby has recovered from the infection. Your baby’s doctor will discuss this with you further.

If you see anyone entering your baby’s room without wearing the correct apparel or not washing their hands, tell your baby’s nurse immediately.

Transfers from other hospitals

If your baby has been in another hospital, the NCCU staff will collect swabs from them to make sure they do not have any antibiotic resistant germs. Your baby will be placed under precautions until the results of the swabs are known; this usually takes between two and four days.

If you have any questions or require further information ask your baby’s nurse to contact a member of the Infection Control team.

Mater acknowledges consumer consultation in the development of this patient information.

Mater Doc Num: PI-CLN-430123

Last modified 09/8/2017.Consumers were consulted in the development of this patient information.Last consumer engagement date: 18/1/2014